Travel Insurance Declinestacy billhartz2020-03-26T22:08:34+00:00 Travel Insurance DeclineI have been offered and advised of travel protection / trip insurance options and fees by my travel agent, from Total Access Travel.Please enable JavaScript in your browser to complete this form.Waiver:I, *FirstLastdecline the offer to purchase travel protection / trip insurance. I understand that I am solely responsible for any cancellation penalties and out-of-pocket expenses incurred. I will also make my own separate travel, medical and any other provisions in the event of an emergency while I am traveling. I also understand that I am not protected from loss in the event of any travel vendor, travel supplier or any travel-related operator default. This waiver confirms that I voluntarily decline travel insurance and travel protection insurance for the trip described above. I understand I am solely liable for all airline fees, supplier fees, and agency fees that may apply, and I hereby release Research Travel, Inc. and its agents from any and all liability related to the trip described above.This waiver must be signed by each adult traveler over 17 years old.Signature 1Clear SignatureDateSignature 2Clear SignatureDateSignature 3Clear SignatureDateSignature 4Clear SignatureDateCommentSubmit